经会阴四维超声评估单切口吊带悬吊术治疗压力性尿失禁  

Perineal four-dimensional ultrasonic assessment of stress incontinence after single incision sling

作　　者：海宁 姜晓红[1] 郭瑞君[1] HAI Ning;JIANG Xiaohong;GUO Ruijun(Department of Ultrasound Medicine,Beijing Chaoyang Hospital,Capital Medical University,Beijing 100020,China)

机构地区：[1]首都医科大学附属北京朝阳医院超声医学科,北京100020

出　　处：《中国医学影像技术》2021年第3期346-349,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的采用会阴四维超声观察单切口吊带悬吊术(SIS)治疗压力性尿失禁(SI)术后转归,分析导致治疗失败的可能因素。方法回顾性分析33例SIS术后6~12个月SI患者盆底超声声像图,以压力诱发实验评估治疗效果,并据此将其分为治疗有效组(n=20)和无效组(n=13),比较2组在静息状态及瓦尔萨尔瓦动作下吊带形态及其相对于尿道的位置等。结果静息状态下所有患者吊带均位于尿道后方,无效组2例出现吊带折叠。静息及瓦尔萨尔瓦动作下,有效组吊带相对于尿道的位置均保持一致,无效组中仅3例保持一致,且此3例于瓦尔萨尔瓦式动作下吊带双侧臂不对称(P<0.05);2组吊带中点与尿道中点最短距离以及吊带成角差异均无统计学意义(P均>0.05)。结论经会阴超声可动态观察SI患者SIS悬吊术术后转归,并有助于了解手术失败原因。Objective To observe the postoperative situation of single incision sling(SIS)in treatment of stress incontinence(SI)with perineal four-dimensional ultrasound,and to explore the possible factors lead to therapeutic failures.Methods Data of pelvic floor ultrasonography of 33 SI patients 6-12 months after SIS were retrospectively analyzed.The patients were divided into 2 groups according to cough stress test,i.e.effective group(n=20)and ineffective group(n=13).The shape and the position of the sling relative to urethra at resting state and under Valsalva maneuver were compared between 2 groups.Results The slings located behind the urethra at the resting state in all patients,while folded in 2 cases of ineffective group.The position of the sling relative to the urethra in effective group was consistent at both at resting state and under Valsalva maneuver,while in ineffective group was consistent in only 3 cases,among them asymmetry of the bilateral arms of the sling was found under Valsalva maneuver(P<0.05).There was no significant difference of the shortest distance between the midpoint of sling and the midpoint of urethra nor the angle of sling between groups(both P>0.05).Conclusion Perineal four-dimensional ultrasound could dynamically observe the situation of SI patients after SIS and help to understand the causes of failures.

关 键 词：压力性尿失禁悬吊术 超声检查 

分 类 号：R694.54[医药卫生—泌尿科学] R445.1[医药卫生—外科学]